A dental crown, often called a cap, is a restoration that fully covers the visible portion of a tooth above the gum line. Its purpose is to protect a significantly damaged, fractured, or weakened tooth, restoring its original shape, size, and function. Crowns are cemented onto the tooth to provide structural strength and improve appearance, often after procedures like a root canal. Although durable, crowns are not indestructible, and a crack or fracture requires prompt professional dental attention.
Immediate Steps for Managing a Cracked Crown
The first action upon noticing a cracked crown is to contact your dentist immediately to schedule an evaluation. While awaiting your appointment, temporary measures can help manage discomfort and prevent additional damage. If the cracked crown has a sharp edge irritating your tongue or cheek, temporarily cover it with a small piece of dental wax to prevent soft tissue injury.
To reduce sensitivity, gently rinse your mouth with warm salt water. Avoid chewing on the damaged side to prevent further fracturing of the crown or the underlying tooth structure. Over-the-counter pain relievers can be used for temporary relief. Remember, this home care is only a short-term solution and does not replace professional assessment and treatment.
Assessing the Damage: When Repair is Possible
The decision to repair or replace a cracked crown depends on the severity and location of the damage. Minor chips or hairline cracks, especially those limited to the outer layer of a porcelain or ceramic crown, are often candidates for repair. The crown’s material is also considered, as all-metal crowns are less likely to crack than porcelain-based ones. A small surface chip that does not compromise the crown’s structural integrity can typically be fixed.
The primary factor determining treatment is the condition of the underlying natural tooth and the integrity of the crown’s margins. If the crack extends deep, compromises the seal at the gum line, or if the underlying tooth is decayed, a simple repair is insufficient. The dentist uses visual inspection and X-rays to check for decay or fracture lines beneath the crown, which necessitates a full replacement. If the crown is merely loose but intact, it may simply be re-cemented.
Professional Treatment Options: Repair or Replacement
Repair Procedures
For minor cracks, repair often involves using composite resin, a tooth-colored plastic material, or dental cement. The dentist roughens the fractured area to create a better bonding surface, applies the resin, and cures it with a special light. This method is quick, usually completed in a single visit, and restores the crown’s smooth surface and aesthetics. However, a bonded repair may not be as durable as the original material and might require future re-polishing.
Replacement Procedures
Crown replacement is necessary when the crack is extensive, the crown is structurally compromised, or the underlying tooth is damaged. The process begins with removing the existing broken crown. The dentist evaluates and prepares the remaining tooth structure, taking a new impression for the permanent crown. A temporary crown is placed to protect the prepared tooth while the new restoration is fabricated in a dental laboratory, typically taking about two weeks.
The new permanent crown is cemented into place during a second appointment. Patients choose materials like porcelain-fused-to-metal (PFM), all-ceramic, or zirconia, based on strength and aesthetic goals. Zirconia and metal alloys offer high durability, while all-ceramic options provide a superior natural appearance, often preferred for front teeth. Replacement ensures a complete, protective barrier against bacteria and biting forces.
Extending the Life of Your Dental Crown
Protecting your dental crown involves adopting specific preventive habits and maintaining consistent oral hygiene. Avoid chewing on hard objects such as ice, hard candies, or pen caps, as the force can easily chip or fracture the crown material. Sticky or chewy foods, like caramels, should also be consumed with caution, as they can potentially dislodge a crown.
If you grind or clench your teeth (bruxism), a custom-fitted nightguard is highly recommended to absorb nocturnal forces. Maintaining rigorous oral hygiene is important, including brushing twice daily and flossing around the crown’s base to prevent decay. Regular dental checkups, usually twice a year, allow the dentist to examine the crown’s integrity and monitor the underlying tooth.